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Nov. 9, 2004. 01:00 AM
TB testing underway in homeless shelters
Two workers being treated
Little risk to public, officials say
MOIRA WELSH
STAFF REPORTER
A massive hunt is underway for the homeless man who infected two Toronto
Salvation Army shelter workers with a virulent strain of tuberculosis.
Toronto Public Health has begun saliva testing of 4,000 homeless men and
shelter workers in an attempt to stem the transmission of the lung
disease in the city's crowded shelter system.
Health officials said there is little risk to the public.
The health department decided to launch the testing campaign after it
discovered late last month that a shelter worker at the Maxwell Meighen
hostel at Sherbourne and Queen Sts. tested positive for the same strain
of active TB contracted by a fellow worker who was tested in July.
Their tuberculosis type matches the strain that was responsible for an
outbreak in the shelter system in 2001. Another four workers at the same
shelter have tested positive for inactive TB, but are currently not sick.
"This is very frightening," said Cathy Crowe, a well-known Toronto
street nurse. "Many of us, including myself, have contracted inactive
TB, but this is the first case I know of where a shelter worker
contracted active TB."
Crowe said that 10 per cent of people with inactive TB, which has no
symptoms and is not infectious, will go on to develop the active strain
in their later years.
"What if this active case of TB is out there, floating around? We don't
know who it is. What if that person is using the Out of the Cold shelter
program...? Many homeless people sleep in a different place every night.
The risk is very, very alarming."
The hunt for the tuberculosis carrier raises the spectre of Toronto's
homeless problem.
With cold weather moving in, more men and women who can't afford other
options are expected to crowd into the city's shelters.
At a news conference yesterday, Toronto's Medical Officer of Health, Dr.
David McKeown, said the department is taking a "very aggressive"
approach to tracking down whoever is ill with the disease.
There are as many as 400 cases of TB reported in Toronto each year, most
of which, McKeown said, were contracted before the carriers came to
Canada and become active later in life.
Among Toronto's homeless, there are between 10 to 15 cases diagnosed
each year.
McKeown said there is little risk to the general public. "Tuberculosis
is transmitted usually through close or prolonged contact. It's not
generally transmitted on the subway, in the workplace, in schools," he said.
Nevertheless, McKeown said, "I think the continuing transmission is a
concern in itself. We shouldn't be satisfied that we have 10 to 15 cases
amongst the homeless each year."
The two shelter workers, who were not identified, are feeling fine,
McKeown said.
"They have begun treatment and are no longer infectious. Normally, when
people have received several weeks of treatment and are not infectious
and they are feeling fine, they can go back to work."
The treatment usually lasts for nine months and involves taking several
different kinds of antibiotics each day, he said.
As for the other four workers who have been diagnosed with inactive TB,
there is no way of knowing what strain they carry unless the disease
becomes active within their system, he said.
The health department expects it will take at least three weeks to
collect the saliva samples, which will be sent to a provincial
laboratory for testing. A May inquest into the 2001 tuberculosis death
of Joseph Teigesser, a homeless man, came out with 13 recommendations,
among them that the province should provide funding for TB prevention,
detection and treatment.
But the inquest's jury didn't deliver the recommendation — suggested by
all parties with standing — that the provincial and federal governments
fund an affordable housing plan to end homelessness, said Crowe.
"For me, it connects with the homeless winter plan. Are we going to open
up more shelters and ones that won't be just a lot of mats crowding
people on the floor?"
Major Ken Percy of the Salvation Army said the Maxwell Meighen hostel is
already running full to capacity every night.
"During a cold snap, they are lining up at 6 a.m. to reserve a bed for
the following evening," Percy said.
Percy said the Maxwell Meighen shelter has some private rooms and many
smaller rooms.